Filippo Marchi, Andrea Iandelli, Gian Marco Pace, Elisa Bellini, Alessandro Tirrito, Andrea Costantino, Luca Cerri, Antonio Greco, Antonella Polimeni, Giampiero Parrinello, Giorgio Peretti, Armando De Virgilio
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A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9-63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%-100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%-6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%-38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). Partial flap necrosis and hematoma occurred in 2.6% of cases (n = 8/307), while arterial and venous thrombosis were documented in 0.7% (n = 2/307) and 1.3%, respectively (n = 4/307).</p><p><strong>Conclusion: </strong>The application of the PAP flap in head and neck reconstructions showed several favorable aspects, such as an exceptionally low flap failure rate, versatility in achieving variable dimensions, and a relatively low incidence of complications. PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.</p>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta-analysis.\",\"authors\":\"Filippo Marchi, Andrea Iandelli, Gian Marco Pace, Elisa Bellini, Alessandro Tirrito, Andrea Costantino, Luca Cerri, Antonio Greco, Antonella Polimeni, Giampiero Parrinello, Giorgio Peretti, Armando De Virgilio\",\"doi\":\"10.1002/hed.27891\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.</p><p><strong>Methods: </strong>A single arm meta-analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).</p><p><strong>Results: </strong>The search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. 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引用次数: 0
摘要
研究目的本研究旨在评估深动脉穿孔器(PAP)皮瓣在头颈部重建中的疗效:方法:对皮瓣存活率(主要结果)、主要并发症再手术率和总体并发症发生率(次要结果)进行单臂荟萃分析:搜索策略共搜索到 295 篇潜在相关文献,其中 13 篇被纳入。共纳入 305 名患者(男性:80.8%,n = 232/281),中位年龄为 56.1 岁(n = 305/305;95% CI 53.9-63),他们因头颈部缺损接受了 307 例 PAP 皮瓣重建术。皮瓣存活率为 100%(n = 306/307;95% CI 99.6%-100%),主要并发症的再手术率为 3.7%(n = 15/307;95% CI 1.85%-6.1%),总并发症率为 26.5%(n = 92/307;95% CI 15.7%-38.9%)。显著的术后并发症包括伤口开裂(n = 15/307,4.9%)、延迟愈合(n = 14/307,4.6%)和伤口感染(n = 12/307,3.9%)。部分皮瓣坏死和血肿发生率为 2.6%(8/307),动脉和静脉血栓形成率分别为 0.7%(2/307)和 1.3%(4/307):结论:PAP皮瓣在头颈部重建中的应用显示出多个有利方面,如皮瓣失败率极低、可实现不同尺寸的多功能性以及并发症发生率相对较低。在头颈部重建中,PAP皮瓣可被视为传统软组织游离皮瓣的替代品。
Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta-analysis.
Objective: This study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.
Methods: A single arm meta-analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).
Results: The search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9-63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%-100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%-6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%-38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). Partial flap necrosis and hematoma occurred in 2.6% of cases (n = 8/307), while arterial and venous thrombosis were documented in 0.7% (n = 2/307) and 1.3%, respectively (n = 4/307).
Conclusion: The application of the PAP flap in head and neck reconstructions showed several favorable aspects, such as an exceptionally low flap failure rate, versatility in achieving variable dimensions, and a relatively low incidence of complications. PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.